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The Facial Feedback Hypothesis (FFH) states that facial emotion recognition is based on the imitation of facial emotional expressions and the processing of physiological feedback. In the light of limited and contradictory evidence, this hypothesis is still being debated. Therefore, in the present study, emotion recognition was tested in patients with central facial paresis after stroke. Performance in facial vs. auditory emotion recognition was assessed in patients with vs. without facial paresis. The accuracy of objective facial emotion recognition was significantly lower in patients with vs. without facial paresis and also in comparison to healthy controls. Moreover, for patients with facial paresis, the accuracy measure for facial emotion recognition was significantly worse than that for auditory emotion recognition. Finally, in patients with facial paresis, the subjective judgements of their own facial emotion recognition abilities differed strongly from their objective performances. This pattern of results demonstrates a specific deficit in facial emotion recognition in central facial paresis and thus provides support for the FFH and points out certain effects of stroke.
Facial Emotion Recognition in Patients with Post-Paralytic Facial Synkinesis : A Present Competence
(2022)
Facial palsy is a movement disorder with impacts on verbal and nonverbal communication. The aim of this study is to investigate the effects of post-paralytic facial synkinesis on facial emotion recognition. In a prospective cross-sectional study, we compared facial emotion recognition between n = 30 patients with post-paralytic facial synkinesis (mean disease time: 1581 ± 1237 days) and n = 30 healthy controls matched in sex, age, and education level. Facial emotion recognition was measured by the Myfacetraining Program. As an intra-individual control condition, auditory emotion recognition was assessed via Montreal Affective Voices. Moreover, self-assessed emotion recognition was studied with questionnaires. In facial as well as auditory emotion recognition, on average, there was no significant difference between patients and healthy controls. The outcomes of the measurements as well as the self-reports were comparable between patients and healthy controls. In contrast to previous studies in patients with peripheral and central facial palsy, these results indicate unimpaired ability for facial emotion recognition. Only in single patients with pronounced facial asymmetry and severe facial synkinesis was an impaired facial and auditory emotion recognition detected. Further studies should compare emotion recognition in patients with pronounced facial asymmetry in acute and chronic peripheral paralysis and central and peripheral facial palsy.